CHILDREN

. Posted in SPECIAL PATIENTS

CAID can affect children as well as adults. Very often, children are misdiagnosed by parents and well-meaning pediatricians as having yet another runny nose or just having a cold. Yet many of these children are congested all year long and are probably suffering from CAID.

A child’s sinuses and nasal passageways are inherently smaller than an adult’s and, therefore, are more easily obstructed. When children experience CAID symptoms, it usually stems from the fact that their sinuses have developed poorly: Their sinus passageways can be unusually small, or their small eustachian tubes are lying horizontally instead of at an angle. Often, their mouth is formed with a high arched palate. These children often breathe with a wide-open mouth, which is referred to as adenoidal facies.

All of these structural conditions can affect the child adversely. Due to constant infection and inflammation, his or her adenoidal bed is swollen and the tonsils are enlarged. Fluid will build up in the ears, leading to a secondary ear infection. Just as with adults, the child’s sinus disease needs to be resolved before the ear infections will resolve. Furthermore, the underlying sinus disease will need to be resolved before the tonsil and the adenoidal infections will clear. Myringotomy, or ear tube placement, can temporarily solve the problem until the child’s eustachian tubes grow larger in diameter and the angle becomes wider, allowing the eustachian tubes to drain the ears better, even in the face of continued chronic sinus infection.

The alteration of dentofacial structures may be caused by the child’s
inability to breathe through his nose. The constant mouth breathing influences the position of his tongue. As in all living things, form follows function. Bone growth is influenced by muscle function, thus the inability of the child to position his tongue appropriately against the dentofacial structures often has a detrimental affect on craniofacial development.

Recent peer-reviewed literature suggests that a time-tested device called the rapid palatal expander can enhance dentofacial development of these children. This device applies gentle pressure to the sutures of the palate in the mouth and the face and encourages new bone development, often aligning the nasal septum and expanding the palate and thus the floor of the nose. This allows children an improved ability to breathe. Recently, this device has been specifically recommended for children who are having difficulty breathing and sleeping at night. The device is fitted to the child’s mouth through fixed orthodontic bands and can be inserted by the child or parent/guardian. Many of the children who received early treatment find that these expanders obviate the need for orthodontics later on because their dental growth is given positive direction by the expander.

Aside from structural issues, the most common symptoms that occur in children with CAID include swollen neck glands, cough, recurrent sore throats, enlarged tonsils, and recurrent strept infections, leading to many missed days of school. When children can’t breathe and have chronic infections, they can experience bouts of recurrent bronchitis, pneumonia, tonsillitis, ear infections, and/or exacerbated asthma.

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